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List Cost on Medicare Radiopharma Claims - 02/05/2021

When billing Medicare for radiopharmaceutical procedure codes, you must list the total acquisition cost on the claim.


Verify Which Health Plans Are Exempt From Prompt Pay Laws - 01/04/2021

Use this tool to affirm which health plans are self-funded and thus not subject to state prompt pay laws. ERISA or TDI?


Make Modifiers Work for You - 01/04/2021

Missing or incorrect coding modifiers are a common reason why claims are denied or physicians are paid incorrectly for their services. Follow these steps to make sure your practice uses modifiers correctly.


NPI Entity Type 1/Type 2 and Medicare Provider Numbers - 12/09/2020

If I am an incorporated physician, do I need two National Provider Identifiers (NPIs)?


Persuasion Collects Debts - 12/03/2020

Persuasion Collects Debts


Timing for Annual Medicare Mammograms - 11/20/2020

Medicare counts 11 full months after the month in which the patient received her screening


Practice E-Tips on Billing and Collections - 11/16/2020

Practice E-Tips on Billing and Collections


Follow These Five Tips When You Follow Up on Claims - 10/26/2020

Follow These Five Tips When You Follow Up on Claims


Practice e-Tips on Coding - 10/20/2020

Get practice tips on all things coding. Learn about coding methods, correct coding, resources, coding related to Workers' Comp and more.


Preauthorization Denial: What’s Your Recourse? - 10/16/2020

So a health plan has denied your preauthorization request for a patient’s treatment. What options do you have?


AMA Creates CPT Codes for Combination COVID-19/Flu Tests - 10/15/2020

The American Medical Association (AMA) has created two new Current Procedural Terminology (CPT) codes for multi-virus testing to detect COVID-19 and influenza.


How Health Plans Are Covering COVID-19 Testing and Treatment - 10/09/2020

Many health insurers in Texas are waiving patient costs associated with COVID-19. Last week in a news release, Gov. Greg Abbott and the Texas Department of Insurance asked insurers and HMOs to cover testing consistent with Centers for Disease Control and Prevention guidance, and telemedicine visits.


TMA: Fair Telemedicine Payments will Ensure Patients’ Care Continues - 09/25/2020

Statement by Texas Medical Association (TMA) President Diana L. Fite, MD, regarding Gov. Greg Abbott’s announcement today that Texas’ state-regulated health plans will continue to pay physicians and health care providers the same rate for patients’ telemedicine care as for in-person care, through the end 2020.


Practice e-Tips on Claims - 09/24/2020

Appeals Appealing Claims Can Have Appealing Results   Claim Forms Multiple Place-of-Service Codes on a Single 1500 Claim Form   Fees New Laws Require Billing Di


More Resources to Get Paid - 09/24/2020

TMA helps physicians “Get Paid.” In 2016, our Hassle Factor Log helped members recover more than $1.8 million in insurance payments.


Practice e-Tips on Reimbursement - 09/24/2020

Billing & Fees Claims Coding & Documentation Collections Copayments & Deductibles Medicaid & Medicare Workers' Comp Billing & Fees Are You Missing Out on Your Money?    Billi


Coding Changes Affect UnitedHealthcare Prior Authorization Lists - 09/23/2020

UnitedHealthcare (UHC) has replaced and added procedure codes on its notification and prior authorization (PA) lists.


Code Carefully for Bilateral Procedures - 09/23/2020

Coding for bilateral procedures can be confusing. Many payers accept CPT modifier 50 as an indicator of a bilateral procedure, but they differ in how they apply it to their coding and payment policies.


Aim for Accuracy in Claims - 09/22/2020

Did you make one of the nearly 1.7 million annual requests to correct minor errors or omissions on a Medicare claim? Novitas Solutions has a new initiative to help you avoid the time and hassle of making corrections.


New Code Accounts for Certain Additional Expenses During Public Health Emergencies - 09/10/2020

The American Medical Association has released a Current Procedural Terminology (CPT) code for reporting additional practice expenses incurred during a public health emergency, including the COVID-19 pandemic.


Reimbursement Review and Resolution (RRR) Services User Guide - 09/09/2020

Please observe the following Reimbursement Review and Resolution (RRR) form guidelines to help us expedite processing while maintaining the integrity and credibility of RRR Services (previously known as the Hassle Factor Log Program).


E&M Coding Changes Among Major CPT Revisions for 2021 - 09/08/2020

The American Medical Association last week released its 2021 Current Procedural Terminology (CPT) code set, which includes major revisions to office and other outpatient evaluation and management (E&M) services designed to decrease physician documentation requirements.


Live Webinar to Help You Prepare for 2021 E&M Coding Changes - 09/01/2020

If you want to learn more about evaluation and management (E&M) coding changes that go into effect Jan. 1, tune in to a live Texas Medical Association webinar: 2021 E/M: Ready Set Go!


The X{EPSU} Modifiers Further Define Modifier 59 - 08/13/2020

Modifier 59, the distinct procedural service modifier associated with Medicare National Correct Coding Initiative edits, is one you might find confusing (many practices do). Follow these guidelines


Don’t Miss New and Revised LCDs - 08/13/2020

Take a look at these new and revised Medicare local coverage determinations (LCDs) and article updates from Novitas Solutions. Remember, Novitas will reject claims that don’t adhere to LCDs.